Easley Jeremiah T, McGilvray Kirk C, Hendrickson Dean A, Bruemmer Jason, Hackett Eileen S
Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado.
Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado.
Vet Surg. 2018 Jun;47(S1):O26-O31. doi: 10.1111/vsu.12755. Epub 2017 Dec 3.
To determine the temperature of a vessel sealer and divider device during unilateral paralumbar laparoscopic ovariectomy in standing, sedated mares.
Prospective study.
Fifteen healthy research mares.
Healthy mares with normal ovarian palpation and ultrasonographic appearance were enrolled. Horses were restrained in standing stocks and sedated. A right or left paralumbar ovariectomy was performed with a laparoscopic portal and 2 instrument portals. Ovaries were excised with traumatic forceps and a blunt tip vessel sealer and divider. Temperatures of the vessel sealer and divider were recorded with a thermocouple device adhered to the tip of the instrument. Variables were reported as median and interquartile range (IQR).
Surgical time was 30 minutes (IQR, 25-32) including use of the vessel sealer and the divider for 4.1 minutes (IQR, 3.2-5.8). The tip of the instrument reached temperatures of 77°C (IQR, 72-85) during activation and 64°C (IQR, 61-67) at end cycle. The median increase in end-cycle instrument tip temperature per activation cycle was 2°C (IQR, -1-6). All mares returned to their intended use.
Despite the instrument temperatures observed during unilateral laparoscopic ovariectomy, surgical complications were minimal. The clinical relevance of the increase in instrument tip temperature of the vessel sealer and divider is presently unclear, but surgeons should use the instrument with caution, especially in close proximity to viscera. The increase in temperature observed at the tip of the vessel sealer and divider during unilateral ovariectomy could be associated with morbidity. The clinical relevance of instrument tip heating during other procedures, such as adhesiolysis and intestinal resection, is unknown and should be evaluated.
测定站立、镇静母马单侧腰旁腹腔镜卵巢切除术期间血管闭合与分割装置的温度。
前瞻性研究。
15匹健康的研究用母马。
纳入卵巢触诊和超声检查外观正常的健康母马。将马固定于站立架并给予镇静。通过一个腹腔镜入口和两个器械入口进行右侧或左侧腰旁卵巢切除术。用创伤钳和钝头血管闭合与分割器切除卵巢。用附着于器械尖端的热电偶装置记录血管闭合与分割器的温度。变量以中位数和四分位数间距(IQR)报告。
手术时间为30分钟(IQR,25 - 32),包括使用血管闭合与分割器4.1分钟(IQR,3.2 - 5.8)。器械尖端在激活期间达到77°C(IQR,72 - 85)的温度,在周期结束时为64°C(IQR,61 - 67)。每个激活周期结束时器械尖端温度的中位数升高为2°C(IQR, - 1 - 6)。所有母马均恢复至预期用途。
尽管在单侧腹腔镜卵巢切除术期间观察到器械温度,但手术并发症极少。目前血管闭合与分割器器械尖端温度升高的临床相关性尚不清楚,但外科医生应谨慎使用该器械,尤其是在靠近内脏时。单侧卵巢切除术期间在血管闭合与分割器尖端观察到的温度升高可能与发病率相关。在其他手术(如粘连松解术和肠切除术)期间器械尖端发热的临床相关性未知,应予以评估。